Cradle Cap and Diaper Rash

Two very common skin conditions called cradle cap and diaper rash will affect many babies during their first few months of life. As the name implies, cradle cap affects the head (or "cap" area) and is usually easy to treat with daily shampooing. Diaper rash, on the other hand, covers a number of different rashes or skin irritations which appear on the lower abdomen, genitals and buttocks. Keep reading to learn the telltale signs of cradle cap and diaper rash and also some suggested treatments.

Coping With Cradle Cap

Cradle cap (seborrheic dermatitis) is a skin condition in which yellowish, scaly, or crusty patches, made up largely of oil and dead skin cells, appear on the scalp. The condition is most common in infants, but it is seen occasionally in children through age five. Some temporary loss of hair may even occur. While the patches most often appear on the scalp, they may extend onto the forehead. They may also appear in the skin fold behind the baby's ears, on the ears themselves, and in the diaper area. The most typical location is over the soft spot (anterior fontanel) on top of the baby's head.

Cradle cap is quite common and not difficult to treat. Mild cases usually clear up with daily shampooing when you use regular baby soap on a wet, rough facecloth wrapped around your hand. Soften the crusts first by massaging a small amount of baby oil into the baby's scalp and letting it remain there overnight. Rub the baby's head vigorously during both the washing and the drying. Don't worry about the soft spots; you won't hurt them. Gently comb the baby's scalp even if your baby has no hair or scrub the scalp with a soft-bristle brush (such as a soft toothbrush).

If regular shampooing doesn't work, you can use a special shampoo that contains coal tar or salicylic acid. Your doctor or pharmacist can recommend one. Ointments containing sulfur, salicylic acid, or coal tar can be used for especially difficult cases. Be especially careful to keep medicated shampoos and ointments out of your baby's eyes, and stop using them if the scalp or skin becomes irritated or red. If the cradle cap doesn't respond to treatment, see your doctor, who can determine if a yeast infection or allergic skin reaction may be causing the problem.

Diaper Rash

When you are bathing or changing your baby, you are likely to see signs of diaper rash; almost all babies have it at one time or another. Diaper rashes may be caused by moisture, urine, or irritating chemicals in diapers, whether cloth or disposable. You can usually identify these rashes by their appearance, their location, and other typical symptoms of different types of rashes.

Simple diaper rash. Simple diaper rashes are red, slightly rough, and scaly. The rash may appear over the whole area touched by the diaper. The skin may be irritated by chemicals used in laundering cloth diapers -- detergent, bleach, whitener, water softener, or soap. Plastic or rubber pants worn over cloth diapers sometimes affect the skin. The skin may also react to the chemicals used in manufacturing disposable diapers.

Ammonia rash. Ammonia rash is a form of diaper rash caused by the urine itself. The skin is literally burned by the ammonia formed when urine is decomposed by normal bacteria on the skin. Not surprisingly, ammonia rash is worse after the child has been asleep for a long period of time without a diaper change. You can identify it by the ammonia smell noticeable when you change the diaper.

Other causes. Besides these two basic diaper rashes, a variety of other rashes may appear in the diaper area, including those caused by an allergy to a food or drug, a skin infection, or a contagious disease, such as chicken pox or measles.

If your baby develops a rash in the diaper area, look for the signs of these different types of rashes. The appearance and location of the rash, an ammonia odor, or a rash elsewhere on the body are all clues. Ask yourself a few pertinent questions to help you and your doctor find the cause of the rash. For example, have you recently switched from cloth to disposable diapers or changed brands of disposables? Have you made any changes in your laundry products? Has the baby been given any new food (a change in formula, perhaps, or the addition of cereal to a feeding) or medication?

Treating Simple Diaper Rash or Ammonia Rash
  • Keep your baby as dry as possible, change diapers frequently, even if they are only slightly wet, and avoid any airtight coverings.
  • If you favor cloth diapers, use double diapers during the daytime, triple diapers at night.
  • Wash the diaper area with plain water each time you change your baby, and apply a protective cream or ointment such as zinc oxide or an ointment combining zinc oxide, cod liver oil, petrolatum, and lanolin. Use only one type of ointment at a time unless your doctor has instructed you to use more than one.
  • Do not dust the baby's skin with cornstarch, a remedy that was once commonly recommended; it has been found to encourage the growth of fungi.
  • Try a different brand of laundry soap on cloth diapers, and do not use fabric softener with every wash because your baby may be sensitive to buildup of it.
  • Give cloth diapers a try if you use disposables, or switch brands. Try disposables if you use cloth diapers.
  • Cut down on the use of powders and oils for your baby, and be sure any you use are mild and non-allergenic.
  • If you use colored toilet tissue to clean your baby's genital area, switch to plain white.
  • To further promote healing, put a pad under the baby and let him lie undiapered when possible to expose the baby's skin to air.
Allergic reaction. An allergic rash from foods or drugs is more likely to occur in an older baby who eats several different kinds of foods or perhaps takes some medication than in one who receives only breast milk or formula. The treatment is to stop giving any new foods, beverages, or medicines started within the past month; then give the child just one of these items each week. If one causes the rash to return, you've found the culprit and can eliminate it. Remember to consult your doctor before starting or stopping medication.

Infections and diseases. To treat a rash caused by an infection or contagious disease, wash the diaper area with water and frequently apply an antibiotic ointment, such as bacitracin or neomycin. If your baby has any other symptoms of illness, such as fever or loss of appetite, if the diaper rash spreads or is severe, or if it gets worse after two days of home treatment, see your doctor. He or she may identify the rash by its appearance or may culture the rash to identify bacteria or fungi. The doctor may prescribe a medicated ointment.

Both cradle cap and diaper rash are treatable skin conditions and generally are not cause for alarm, as many babies will experience one or both in their lives. By familiarizing yourself with the symptoms of each, you may prevent future anxiety.

As you've seen in this article, adjusting to life with a newborn isn't easy. But if you arm yourself with the right tools and information, you can stay a step ahead of the game.

Publications International, Ltd.

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